US7202211B2 - Methods of preventing or treating brain ischemia or brain injury - Google Patents

Methods of preventing or treating brain ischemia or brain injury Download PDF

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US7202211B2
US7202211B2 US10/371,725 US37172503A US7202211B2 US 7202211 B2 US7202211 B2 US 7202211B2 US 37172503 A US37172503 A US 37172503A US 7202211 B2 US7202211 B2 US 7202211B2
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narp
taipoxin
gamma
mcao
patient
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Alexander Faerman
Sylvia G. Kachalsky
Gregory Hirsch Idelson
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Astellas Pharma Inc
Yamanouchi Pharmaceutical Co Ltd
Quark Pharmaceuticals Inc
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    • G01N33/502—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing or evaluating the effect of chemical or biological compounds, e.g. drugs, cosmetics for testing non-proliferative effects
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
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    • G01N33/502—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing or evaluating the effect of chemical or biological compounds, e.g. drugs, cosmetics for testing non-proliferative effects
    • G01N33/5041—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells for testing or evaluating the effect of chemical or biological compounds, e.g. drugs, cosmetics for testing non-proliferative effects involving analysis of members of signalling pathways
    • G—PHYSICS
    • G01—MEASURING; TESTING
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    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
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    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/5005—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving human or animal cells
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    • G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/68—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids
    • G01N33/6893—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving proteins, peptides or amino acids related to diseases not provided for elsewhere
    • G01N33/6896—Neurological disorders, e.g. Alzheimer's disease

Definitions

  • the present invention relates to use of a Narp inhibitor, in order to promote and enhance recovery from ischemic events, particularly ischemia of the central nervous system, as well as for preventing or diminishing chronic degenerative changes to the central nervous system.
  • ionotropic glutamate receptors are the major excitatory neurotransmitter receptors and are divided into three broad classes, termed AMPA-, NMDA-, and kainate-type receptors, on the basis of molecular and pharmacological criteria.
  • the predominant charge carrier during routine fast excitatory synaptic transmission is the AMPA-type receptor.
  • Functional AMPA receptors are constructed from subunits termed glutamate receptors subunits 1–4 (GluR 1 –GluR 4 ).
  • NARP has been independently identified as the guinea pig sperm acrosome protein p50/apexin (Noland, T. D. et al. (1994) J. Biol. Chem . 269, 32607; Reid, M. S., and Blobel, C. P. (1994) J Biol. Chem . 269, 32619).
  • Narp may form multimers that subsequently act directly on the AMPA receptor, specifically the GluR 1-3 subunits, inducing their clustering. Narp appears to derive from both pre- and post synaptic sources. Taken together, these data suggest that Narp may function to facilitate the formation of new excitatory synapses. Since Narp is an Immediate Early Gene (IEG) regulated by synaptic activity, its dynamic expression provides a novel mechanism for activity-dependent synaptogenesis and synaptic plasticity.
  • IEG Immediate Early Gene
  • U.S. Pat. No. 5,762,552 discloses purified Narp polypeptide, including its amino acid sequence, while WO 97/39133 also provides the polynucleotide encoding the Narp polypeptide, the expression vector containing the above polynucleotides sequence, and a host cell transformed with this vector. Based on the fact that Narp is useful for induction of dendritic neurite outgrowth as well as promotion of neural migration, this patent discloses a method for treating a patient having neuronal disorders, utilizing administration of Narp to the patient.
  • EP 1,101,820A1 discloses the nucleic acid sequences encoding both human neuronal pentraxin receptor (NPR) and pentraxin I (NP1), and the application is directed to pentraxin I. It only briefly mentions pentraxin II, which is Narp.
  • WO 00/75661 provides a method for identifying compounds that affect the formation of AMPA receptors into aggregates.
  • WO 00/75661 discloses methods for treating a patient having disorders associated with either an increase or a decrease in the function/expression of Narp, by administering to the patient agents that augment or inhibit Narp function/expression, respectively.
  • WO 00/75661 discloses stimulation of NARP expression or activity for treatment of neuronal cell disorders including stroke or brain or spine cord injury damage including ischemic injury.
  • Brain injury such as trauma and stroke are among the leading causes of mortality and disability in the western world.
  • Traumatic brain injury is one of the most serious reasons for hospital admission and disability in modern society. Clinical experience, suggests that TBI may be classified into primary damage occurring immediately after injury, and secondary damage, which occurs during several days post injury. Current therapy of TBI is either surgical or else mainly symptomatic.
  • Cerebrovascular diseases occur predominately in the middle and late years of life. They cause approximately 200,000 deaths in the United States each year as well as considerable neurologic disability. The incidence of stroke increases with age and affects many elderly people, a rapidly growing segment of the population. These diseases cause either ischemia-infarction or intracranial hemorrhage.
  • Stroke is an acute neurologic injury occurring as a result of interrupted blood supply, resulting in an insult to the brain.
  • Most cerebrovascular diseases present as the abrupt onset of focal neurologic deficit. The deficit may remain fixed, it may improve or progressively worsen, leading usually to irreversible neuronal damage at the core of the ischemic focus, whereas neuronal dysfunction in the penumbra may be treatable and or reversible.
  • Prolonged periods of ischemia result in frank tissue necrosis. Cerebral edema follows and progresses over the subsequent 2 to 4 days. If the region of the infarction is large, the edema may produce considerable mass effect with all of its attendant consequences.
  • Neuroprotective drugs are being developed in an effort to rescue neurons in the penumbra from dying, though as yet none has been proven efficacious.
  • Damage to neuronal tissue can lead to severe disability and death.
  • the extent of the damage is primarily affected by the location and extent of the injured tissue. Endogenous cascades activated in response to the acute insult play a role in the functional outcome. Efforts to minimize, limit and/or reverse the damage have the great potential of alleviating the clinical consequences.
  • Taipoxin is a presynaptic toxin contained in the venom of the Australian taipan snake ( Oxyuranus s. scutellatus ). Fohlman J, (1976) Eur J Biochem 68 457–69.
  • the intact complex molecule of taipoxin is composed of ⁇ , ⁇ and gamma ( ⁇ ) subunits.
  • Gamma-taipoxin is composed of 133 amino acids and has a molecular weight of 14.6 Kda. It is the only subunit of taipoxin which is N-glycosylated and sialyzed.
  • Taipoxin is known to bind Narp; in fact, Narp was first purified on an affinity column of taipoxin (Kirkpatrick et al (2000) Biochemical Interactions of the Neuronal Pentraxins. The Journal of Biological Chemistry, 275, 23: 17786–17792), and identified through its interaction with taipoxin.
  • NPR Narp and Narp receptor
  • 4,341,762 concerns the possibility of using combinations of different types of toxins (among them taipoxin) isolated from snake venoms for treatment of neurological and related disorders.
  • taipoxin taipoxin isolated from snake venoms
  • the toxicity of the full taipoxin is 2 ug/Kg.
  • the toxicity of ⁇ or ⁇ + ⁇ subunits is highly increased by addition of ⁇ , suggesting that ⁇ is involved in interaction with specific proteins on cell surface.
  • the interaction possibly includes the carbohydrate moiety of ⁇ subunit.
  • the ⁇ subunit ( ⁇ 1 and ⁇ 2) was found to be non-toxic and mitogenic (Lipps (2000) Toxicon 38 1845–1854), and has been proposed as a growth cell factor and for the treatment of wounds (U.S. Pat. Nos. 6,316,602 and 6,307,031).
  • U.S. Pat. No 6,316,602 relates to the use of beta-taipoxin as a cell-growth factor. This patent is directed primarily to methods of separating beta-taipoxin from the other subunits.
  • PCT publication No. WO 01/63293 is directed to identification of a long list of proteins and protein isoforms, and the use of these proteins and nucleic acids for screening, diagnosis and therapy of Schizophrenia.
  • a screening method for treating schizophrenia which employs Pentraxin I in order to cause neuronal cells to be susceptible to taipoxin activity is disclosed.
  • the present invention provides compositions and methods for alleviation or reduction of the symptoms and signs associated with damaged neuronal tissues whether resulting from tissue trauma, or from chronic degenerative changes. It is an object of the present invention to provide pharmaceutical compositions to reduce or even to completely diminish tissue damage or degeneration due to acute injury to the CNS as described or due to other insults. It is a further object of the present invention to provide methods leading to functional improvement after traumatic ischemic events, including but not limited to traumatic brain injury (TBI) or cerebral stroke. These effects will be achieved by administering an agent that interacts with Narp molecules, and consequently prevents the effect of Narp on AMPA type glutamate receptors.
  • TBI traumatic brain injury
  • the present invention provides polypeptides, compositions and methods for alleviation or reduction of the symptoms and signs associated with damaged neuronal tissues whether resulting from tissue trauma, or from chronic degenerative changes. It is an object of the present invention to provide pharmaceutical compositions to reduce or even to completely diminish tissue damage or degeneration. It is a further object of the present invention to provide methods leading to functional improvement after traumatic ischemic events. These effects will be achieved by administering an agent that interacts with Narp molecules, and consequently prevents the effect of Narp.
  • Narp also termed neuronal activity regulated pentraxin or neuronal pentraxin II
  • mRNA messenger RNA
  • IEG immediate-early gene
  • Narp has homology to members of the pentraxin family of secreted lectins that include C-reactive protein (CRP) and serum amyloid P (SAP) component.
  • CRP C-reactive protein
  • SAP serum amyloid P
  • Narp is characterized by a cyclic pentameric structure and radial symmetry. The five identical 24-kDa protomers consist of 206 amino acids, and are noncovalently linked.
  • Narp binds to GluR1 AMPA receptor subunit in a calcium dependent manner, and that its suggested functions are neurite-outgrowth promoting activity (role in excitatory synaptogenesis) and extracellular aggregating factor for AMPA receptors, targeting against Narp may decrease the “excitotoxic” damage mediated by AMPA receptors at the early stages of the ischemic event.
  • the present invention is based, inlet alia, on the finding by the inventors that in animals which were subjected to middle cerebral artery occlusion (MCAO), an ischemia (stroke) model, the Narp RNA level was significantly upregulated (as compared to controls) following the onset of the ischemic event.
  • MCAO middle cerebral artery occlusion
  • stroke ischemia
  • the present invention utilizes a polypeptide, antibody, or a small chemical compound that binds Narp, thus preventing Narp biological activity.
  • an antibody directed to a neural activity-regulated pentraxin peptide or its immunoreactive fragments is provided.
  • a polypeptide which binds to a neural activity-regulated pentraxin peptide or fragments thereof is provided.
  • a small chemical compound which binds to a neural activity-regulated pentraxin polypeptide or fragments thereof is provided.
  • Narp refers to the Narp (neural activity-regulated pentraxin) polypeptide and is understood to include “neuronal activated pentraxin” (or pentaxin), “pentraxin II” “pentaxin II”, and “NP2”, derived from any organism, preferably man or mice, and homologs thereof having similar biological activity, preferably having 70%, 80%, 90% or even 95% homology to the Narp polypeptide.
  • “biological effect of Narp” or “Narp biological activity” is meant the effect of Narp on AMPA type glutamate receptors, which may be direct or indirect, and includes, without being bound by theory, Neurite-outgrowth promoting activity, and a function as an extracellular aggregating factor for AMPA receptors, which includes an inhibitory effect wherein Narp causes clustering of AMPA receptors on the surface of a cell.
  • the glutamate receptors are preferably on the surface of neuronal cells; the indirect effect includes, but is not limited to, Narp binding to or having an effect on one of several molecules which are involved in a signal transduction cascade resulting in an effect on AMPA type glutamate receptors.
  • Narp inhibitor is meant any molecule, whether a polypeptide, antibody, or small chemical compound, that prevents or reduces the biological effect of Narp, as recited above.
  • Narp inhibitor may also be an inhibitor of the Narp promoter such as inter alia, antisense RNA molecule, dominant negative peptide (see, for example, O'Brien et al., Synaptically Targeted Narp Plays an Essential Role in the Aggregation of AMPA Receptors at Excitatory Synapses in Cultures Spinal Neurons, Journal of Neuroscience 22(11): 4487–4498, 2002, which discloses Narp dominant negative mutants that inhibit Narp activity).
  • a preferred Narp inhibitor is gamma-taipoxin.
  • antibody as used in the present invention is meant both poly- and mono-clonal complete antibodies as well as fragments thereof, such as Fab, F(ab′) 2 , and Fv, which are capable of binding the epitopic determinant.
  • Fab fragment antigen binding domain
  • epitopic determinants an antigenic determinant on an antigen to which the antibody binds.
  • Epitopic determinants usually consist of chemically active surface groupings of molecules such as amino acids or sugar side chains and usually have specific three dimensional structural characteristics, as well as specific charge characteristics.
  • Polypeptide is meant a molecule composed of amino acids and the term includes peptides, polypeptides, proteins and peptidomimetics.
  • amino acid refers to a molecule which consists of any one of the 20 naturally occurring amino acids, amino acids which have been chemically modified (see below), or synthetic amino acids.
  • chemical compound small molecule
  • chemical molecule small chemical compound
  • small chemical compound refers to chemical moieties of any particular type which may be synthetically produced or obtained from natural sources and typically have a molecular weight of less than 2000 daltons, more preferably less than 1000 daltons or even less than 600 daltons.
  • homolog/homology is meant at least about 70%, preferably at least about 75% homology, advantageously at least about 80% homology, more advantageously at least about 90% homology, even more advantageously at least about 95%, e.g., at least about 97%, about 98%, about 99% or even about 100% homology.
  • the invention also comprehends that these polynucleotides and polypeptides can be used in the same fashion as the herein or aforementioned polynucleotides and polypeptides.
  • homology can refer to the number of positions with identical nucleotides or amino acid residues, divided by the number of nucleotides or amino acid residues in the shorter of the two sequences, wherein alignment of the two sequences can be determined in accordance with the Wilbur and Lipman algorithm ((1983) Proc. Natl. Acad. Sci. USA 80:726), for instance, using a window size of 20 nucleotides, a word length of 4 nucleotides, and a gap penalty of 4, and computer-assisted analysis and interpretation of the sequence data, including alignment can be conveniently performed using commercially available programs (e.g., IntelligeneticsTM Suite, Intelligenetics Inc., Calif.).
  • RNA sequences are said to be similar, or to have a degree of sequence identity or homology with DNA sequences, thymidine (T) in the DNA sequence is considered equal to uracil (U) in the RNA sequence.
  • RNA sequences within the scope of the invention can be derived from DNA sequences or their complements, by substituting thymidine (T) in the DNA sequence with uracil (U).
  • amino acid sequence similarity or homology can be determined, for instance, using the BlastP program (Altschul el al., Nucl. Acids Res. 25:3389–3402) and available at NCBI.
  • the following references provide algorithms for comparing the relative identity or homology of amino acid residues of two polypeptides, and additionally, or alternatively, with respect to the foregoing, the teachings in these references can be used for determining percent homology: Smith et al., (1981) Adv. Appl. Math. 2:482–489; Smith et al., (1983) Nucl. Acids Res. 11:2205–2220; Devereux et al., (1984) Nucl. Acids Res.
  • the present invention is based, inter alia, on the observation by the inventors that occlusion of a cerebral artery, which serves as a model for stroke or other ischemic and hypoxic events, induces significant elevation in Narp transcription as determined by the levels of Narp RNA compared to controls, and on the fact that Narp interacts with certain subunits of AMPA receptors, and subsequently causing their clustering.
  • the present invention discloses for the first time the utility of Narp inhibition and the utilization of anti-Narp antibodies, Narp inhibitors, use of gamma-taipoxin, small molecules, antisense RNAs, or ribozymes for inhibition of Narp function.
  • NARP antibody or other peptide Narp inhibitors or small molecule Narp inhibitors prevent the effect of Narp on Glutamate receptors, possibly the clustering of Glutamate receptors, thereby improving clinical and recovery outcome after brain ischemia or tissue trauma.
  • BBB blood brain barrier
  • NARP effect of NARP in the clustering of Glutamate receptors in post-synaptic terminals in the brain as well as its up-regulation following stroke are detrimental.
  • inhibition of the interaction between NARP and the glutamate receptors in the post-synaptic terminals may inhibit the clusters of AMPA receptors in the synapse and inhibit and/or decrease AMPA receptor driven excitotoxicity.
  • inhibitors of Narp apart from gamma taipoxin or anti-Narp antibody, may inhibit (prevent) the effect of Narp on Glutamate receptors.
  • Such inhibitors are inter alia polypeptides capable of inhibiting the effect of NARP (both dominant negative peptides and/or extracellular polypeptides that inhibit the clustering-see, for example, Mi et al., Differing Mechanisms for Glutamate Receptor Aggregation on Dendritic Spines and Shafts in Cultures Hippocampal Neurons. The Journal of Neuroscience , 22(17): 7606–7616, 2002) and antisense oligonucleotides such as peptide antagonists, synthetic small molecule antagonists, antisense RNAs, or ribozymes.
  • the present approach has several distinct advantages over any hitherto available or suggested therapies, including a longer therapeutic effect while preserving the favorable or beneficial effects.
  • One aspect of this invention provides for a polypeptide that binds to Narp.
  • This polypeptide may be, but is not limited to, an antibody or a portion of a toxin.
  • Binding of said polypeptide to Narp may occur through a specific binding site or epitope.
  • This binding site is characterized by the fact that it confers to Narp the possibility of executing any of the activities attributed to Narp, including but not limited to neurite-outgrowth promoting activity and function as an extracellular aggregating factor for AMPA receptors.
  • This binding site is further characterized by the fact that binding of the polypeptide of the invention to Narp through this binding site prevents or reduces the biological activity of Narp, including but not limited to Neurite-outgrowth promoting activity and function as an Extracellular aggregating factor for AMPA receptors.
  • the claimed polypeptide is an antibody that inhibits the binding of a murine antibody to Narp, preferably through the same binding site. This inhibition may be tested by methods known to those skilled in the art.
  • Another aspect of this invention provides for a pharmaceutical composition
  • a pharmaceutical composition comprising a Narp inhibitor, preferably a polypeptide, preferably an antibody or a portion of a toxin, preferably taipoxin.
  • this pharmaceutical composition is used for alleviation or reduction of the symptoms and signs associated with damaged neuronal tissues whether resulting from tissue trauma, or from chronic degenerative changes.
  • the Narp inhibitor may cause inhibition of Narp biological activity through several pathways, preferably through binding.
  • Bound Narp may cease to possess Narp activity due to inactivation of a site or an epitope which is crucial to Narp activity (as is possible, for example, in the case of an inhibitor which is a small chemical compound or a portion of a toxin), or due to a spatial interference caused by the bound inhibitor (as is possible for example in the case of an antibody or a portion of a toxin).
  • Narp may no longer possess the possibility of Narp biological activity, which may include, but is not limited to Neurite-outgrowth promoting activity, and a function as an extracellular aggregating factor for AMPA receptors (which includes an inhibitory effect wherein Narp causes clustering of AMPA receptors on the surface of a cell).
  • This prevention of Narp biological activity may aid in alleviation or reduction of the symptoms and signs associated with damaged neuronal tissues whether resulting from tissue trauma, or from chronic degenerative changes.
  • portion of a toxin is meant a complete subunit or fragment thereof, having the capacity to bind Narp, preferably derived from the toxin taipoxin, most preferably from gamma-taipoxin.
  • a portion of a toxin is used in a pharmaceutical composition
  • a pharmaceutical composition comprising as an active ingredient a Narp inhibitor (said portion of a toxin) further comprising a pharmaceutically acceptable diluent or carrier.
  • said toxin is taipoxin.
  • a preferred embodiment of this invention is the usage of gamma-taipoxin, or a fragment thereof, as a Narp inhibitor in a pharmaceutical composition comprising as an active ingredient a Narp inhibitor further comprising a pharmaceutically acceptable diluent or carrier, for alleviation or reduction of the symptoms and signs associated with neuronal damage.
  • Gamma-taipoxin was found to be non-toxic by the inventors of the present invention, as detailed below in Example 3.
  • the pharmaceutical composition described in this invention may further contain a diluent or carrier.
  • gamma-taipoxin refers to the gamma subunit of the taipoxin polypeptide, fragments thereof retaining binding activity, and homologs thereof, preferably having at least 70%, more preferably at least 80%, even more preferable at least 90% or 95% homology thereto. This term is understood to encompass polypeptides resulting from minor alterations in the gamma-taipoxin coding sequence, such as, inter alia, point mutations, deletions and insertions which may cause a difference in a few amino acids between the resultant polypeptide and the naturally occurring gamma-taipoxin.
  • Polypeptides encoded by nucleic acid sequences which bind to the gamma-taipoxin coding sequence or genomic sequence under conditions of highly stringent hybridization which are well-known in the art (for example Ausubel et al., Current Protocols in Molecular Biology, John Wiley and Sons, Baltimore, Md. (1988), updated in 1995 and 1998), are also encompassed by this term.
  • Chemically modified gamma-taipoxin or chemically modified fragments of gamma-taipoxin are also included in the term, so long as the binding activity is retained.
  • the polypeptide sequence of gamma-taipoxin is depicted in FIG. 5 (SEQ ID No: 7).
  • Particular fragments of the gamma-taipoxin polypeptide include amino acids 1–20, 21–40, 41–60, 61–80, 81–100, 101–120 and 121–133 of SEQ ID No: 7. Further particular fragments of the gamma-taipoxin polypeptide include amino acids 10–30, 31–50, 51–70, 71–90, 91–110 and 111–133 of SEQ ID No: 7.
  • binding activity refers to the ability of gamma-taipoxin to bind to Narp.
  • a preferred embodiment of the present invention concerns a method for alleviating or reducing damage to the central nervous system in a patient who has suffered an injury to the central nervous system, comprising administering to the patient a pharmaceutical composition comprising as an active ingredient a Narp inhibitor further comprising a pharmaceutically acceptable diluent or carrier, in a sufficient dosage to alleviate or reduce the damage
  • Another preferred embodiment of the present invention concerns a method for promoting or enhancing recovery in a patient who has suffered an injury to the central nervous system, the method comprising administering to the patient a pharmaceutical composition comprising as an active ingredient a Narp inhibitor further comprising a pharmaceutically acceptable diluent or carrier, in a sufficient dosage to promote or enhance the recovery.
  • the injury to the central nervous system which said pharmaceutical composition is aimed at alleviating or reducing, or from which said pharmaceutical composition is aiming to promote or enhance recovery is an ischemic episode, which may be, but is not limited to, a global or focal cerebral episode.
  • ischemic episode is meant any circumstance that results in a deficient supply of blood to a tissue. Cerebral ischemic episodes result from a deficiency in the blood supply to the brain.
  • the spinal cord which is also part of the central nervous system, is equally susceptible to ischemia resulting from diminished blood flow.
  • An ischemic episode may be caused by hypertension, hypertensive cerebral vascular disease, rupture of aneurysm, a constriction or obstruction of a blood vessel- as occurs in the case of a thrombus or embolus, angioma, blood dyscrasias, any form of compromised cardiac function including cardiac arrest or failure, systemic hypotension, cardiac arrest, cardiogenic shock, septic shock, spinal cord trauma, head trauma, seizure, bleeding from a tumor, or other blood loss. It is expected that the invention will also be useful for treating injuries to the central nervous system that are caused by mechanical forces, such as a blow to the head or spine.
  • Trauma can involve a tissue insult such as an abrasion, incision, contusion, puncture, compression, etc., such as can arise from traumatic contact of a foreign object with any locus of or appurtenant to the head, neck, or vertebral column.
  • Other forms of traumatic injury can arise from constriction or compression of CNS tissue by an inappropriate accumulation of fluid (for example, a blockade or dysfunction of normal cerebrospinal fluid or vitreous humor fluid production, turnover, or volume regulation, or a subdural or intracarnial hematoma or edema).
  • traumatic constriction or compression can arise from the presence of a mass of abnormal tissue, such as a metastatic or primary tumor.
  • focal ischemia as used herein in reference to the central nervous system, is meant the condition that results from the blockage of a single artery that supply blood to the brain or spinal cord, resulting in the death of all cellular elements (pan-necrosis) in the territory supplied by that artery.
  • global ischemia as used herein in reference to the central nervous system, is meant the condition that results from general diminution of blood flow to the entire brain, forebrain, or spinal cord, which causes the death of neurons in selectively vulnerable regions throughout these tissues.
  • the pathology in each of these cases is quite different, as are the clinical correlates.
  • Models of focal ischemia apply to patients with focal cerebral infarction, while models of global ischemia are analogous to cardiac arrest, and other causes of systemic hypotension.
  • an additional pharmaceutically effective compound is administered in conjunction with the aforementioned pharmaceutical composition.
  • One embodiment of the claimed invention provides for the preparation of a medicament for the treatment of a patient who has suffered an injury to the central nervous system, using a Narp inhibitor.
  • the Narp inhibitor can be any one of those described herein, and is preferably a polypeptide.
  • the treatment regimen according to the invention is carried out, in terms of administration mode, timing of the administration, and dosage, so that the functional recovery of the patient from the adverse consequences of the ischemic events or central nervous system injury is improved; i.e., the patient's motor skills (e.g., posture, balance, grasp, or gait), cognitive skills, speech, and/or sensory perception (including visual ability, taste, olfaction, and proprioception) improve as a result of antibody administration according to the invention.
  • the patient's motor skills e.g., posture, balance, grasp, or gait
  • cognitive skills e.g., speech, and/or sensory perception
  • visual ability, taste, olfaction, and proprioception e.g., visual ability, taste, olfaction, and proprioception
  • Administration of the antibody or polypeptide or small chemical compound according to the invention can be carried out by any known route of administration, including intravenously, intra-arteially, subcutaneously, or intracerebrally. Using specialized formulations, particularly in the case of active fragments of the anti-Narp antibodies, it may also be possible to administer these orally or via inhalation. Suitable doses and treatment regimens for administering antibodies to an individual in need thereof are discussed in detail below.
  • the invention can be used to treat the adverse consequences of central nervous system injuries that result from any of a variety of conditions. Thrombus, embolus, and systemic hypotension are among the most common causes of cerebral ischemic episodes. Other injuries may be caused by hypertension, hypertensive cerebral vascular disease, rupture of an aneurysm, an angioma, blood dyscrasias, cardiac failure, cardiac arrest, cardiogenic shock, septic shock, head trauma, spinal cord trauma, seizure, bleeding from tumor, or other blood loss.
  • ischemia is associated with stroke, it can be either global or focal ischemia, as defined below. It is believed that the administration of an antibody according to the invention is effective, even though administration occurs a significant amount of time following the injury.
  • a preferred embodiment of the present invention concerns a pharmaceutical composition
  • a pharmaceutical composition comprising gamma-taipoxin and a pharmaceutically acceptable carrier.
  • a composition comprising gamma-taipoxin in an amount effective to treat an injury to the nervous system and a carrier
  • the carrier may be a pharmaceutically acceptable carrier; further, the composition may be used to treat a patient who has suffered an injury to the central nervous system, such as an ischemic episode, which may be global or focal, or a stroke, by administering- the pharmaceutical composition in a dose sufficient to promote recovery and thereby treat the patient.
  • the administration of the pharmaceutical composition may be periodical.
  • periodical in the context of the administration of a pharmaceutical composition and as used herein is meant administering the pharmaceutical composition in fixed intervals, preferably at fixed times. Such intervals may range from once an hour or every few hours, to once a day, or once every few days or even once a week. More information on dosage and administration regimens is provided in Example 5 below.
  • An additional embodiment of the present invention concerns the use of gamma-taipoxin in the preparation of a medicament, which may be used for treating a patient who has suffered an injury to the central nervous system, such as, inter alia, a stroke.
  • Another embodiment of the present invention involves a process of identifying a species that modulates binding between Narp and gamma-taipoxin, comprising the steps of:
  • the so identified species may enhance the binding between Narp and gamma-taipoxin.
  • the term “species” encompasses, inter alia, small chemical molecules, antibodies, antisense oligonucleotides, antisense DNA or RNA molecules, proteins, polypeptides and peptides including peptido-mimetics, expression vectors, lipids, carbohydrates and any other molecule capable of interacting with a naturally occurring molecule.
  • the present invention provides for a process of identifying a species that possesses the binding activity of gamma-taipoxin comprising the steps of:
  • An additional aspect of the present invention comprises a process of identifying a species that possesses the binding activity of gamma-taipoxin comprising the steps of:
  • the present invention provides for a process of identifying a species that possesses the binding activity of gamma-taipoxin comprising the steps of:
  • the species identified according to any one of the preceding methods may be a chemical compound.
  • the detection of binding between Narp and gamma-taipoxin may be performed according to methods known in the art; one preferable method is to perform the screening processes of the present invention with an immuno-fluoresent detection system.
  • one preferable method is to perform the screening processes of the present invention with an immuno-fluoresent detection system.
  • an antibody, a polypeptide or a small chemical compound can be administered hours, days, or even weeks, following an injury to the central nervous system. This is advantageous because there is no way to anticipate when such an injury will occur. All the events that cause ischemia or trauma, as discussed above, are unpredictable. Second, this therapeutic regimen improves functional performance without adverse side effects.
  • Constant substitution refers to the substitution of an amino acid in one class by an amino acid of the same class, where a class is defined by common physicochemical amino acid side chain properties and high substitution frequencies in homologous proteins found in nature, as determined, for example, by a standard Dayhoff frequency exchange matrix or BLOSUM matrix.
  • Six general classes of amino acid side chains have been categorized and include: Class I (Cys); Class II (Ser, Thr, Pro, Ala, Gly); Class III (Asn, Asp, Gin, Glu); Class IV (His, Arg, Lys); Class V (Ile, Leu, Val, Met); and Class VI (Phe, Tyr, Trp).
  • substitution of an Asp for another class III residue such as Asn, Gin, or Glu, is a conservative substitution.
  • Non-conservative substitution refers to the substitution of an amino acid in one class with an amino acid from another class; for example, substitution of an Ala, a class II residue, with a class III residue such as Asp, Asn, Glu, or Gin.
  • “Chemically modified” when referring to the product of the invention, is meant a product (polypeptide) where at least one of its amino acid residues is modified either by natural processes, such as processing or other post-translational modifications, or by chemical modification techniques which are well known in the art.
  • modifications typical, but not exclusive examples include: acetylation, acylation, amidation, ADP-ribosylation, glycosylation, GPI anchor formation, covalent attachment of a lipid or lipid derivative, methylation, myristlyation, pegylation, prenylation, phosphorylation, ubiqutination, or any similar process.
  • Expression vector refers to vectors that have the ability to incorporate and express heterologous DNA fragments in a foreign cell. Many prokaryotic and eukaryotic expression vectors are known and/or commercially available. Selection of appropriate expression vectors is within the knowledge of those having skill in the art.
  • deletion is a change in sequence of either nucleotide or amino acid molecule in which one or more nucleotides or amino acid residues, respectively, are absent.
  • Insertion or “addition”—is that change in a sequence of a nucleotide or amino acid molecule resulting in the addition of one or more nucleotides or amino acid residues, respectively, as compared to the naturally occurring molecule.
  • substitution refers to the replacement of one or more nucleotides or amino acids by different nucleotides or amino acids, respectively. As regards amino acid sequences the substitution may be conservative or non-conservative.
  • FIGS. 1A and 1B are the Human Narp open-reading frame (cDNA) and translation to corresponding polypeptide, SEQ ID No: 1 and SEQ ID No: 2 respectively;
  • FIGS. 2A and 2B are the Rat Narp open-reading frame (cDNA) and translation to corresponding polypeptide, SEQ ID No: 3 and SEQ ID No: 4 respectively;
  • FIGS. 3A , 3 B and 3 C are a homology comparison between the nucleotide sequences of Rat, Mouse, and Human Narps; SEQ ID of Rat and Human Narp nucleotide sequences are as above (SEQ ID No: 3 and 1 respectively); SEQ ID No of Mouse nucleotide sequence is SEQ ID No: 5 and the corresponding polypeptide is SEQ ID No: 6.
  • FIG. 4 is a homology comparison between the amino-acid sequences of Rat, Mouse, and Human Narps, SEQ ID No: 4, 6 and 2 respectively;
  • FIG. 5 is the amino acid sequence of gamma-taipoxin, SEQ ID No: 7.
  • the polynucleotide encoding Narp was found by: microarray-based differential gene expression, evaluated by both in vivo and in vitro models.
  • the cDNA microarray was constructed by combining cDNA libraries (Table 1), including a subtraction library, enriched for stroke specific genes. As a result, the Stroke chip consists of low-redundant stroke-specific clones. The microarray contains 10,000 cDNA clones. The libraries printed on the chip were as described in Table 1.
  • MCAO Middle cerebral artery occlusion
  • FK506 (tacrolimus) is a known immunosuppressive agent produced by Streptomyces tsukubaesis .
  • FK506 possesses neuroprotective activity by delaying or preventing hypoxia-induced death of neuronal cells. In addition, it can cause re-growth of damaged nerve cells.
  • the specific molecular mechanism underlying the neuroprotective activity of FK506 is largely unknown although there are indications for suppression of activities of calcineurin and nitric oxide synthase as well as prevention of stroke induced generation of ceramide and Fas signaling.
  • FK 506 serves for pinpointing genes that are not only regulated by ischemic-induced damage but are also regulated by the addition of FK-506.
  • MCAO middle cerebral artery occlusion
  • MCA middle cerebral artery occlusion
  • the in vitro model was used was rat primary cortical neuron cultures exposed to either normal oxygen concentrations or hypoxia, with or without FK506 treatment.
  • the present invention is directed to inhibitors of NARP polypeptide the expression of which in neural cells is modulated when cells are subjected to neurotoxic stress.
  • the first technique is known as the “Stroke Chip”, on which cDNA fragments that correspond to genes that are believed to be stroke specific were imprinted. These clones were obtained from brain tissue of rats subjected to MCAO and from primary neurons treated in vitro under hypoxic conditions.
  • Stroke Chip the cDNA microarray was constructed by combining various types of libraries.
  • An ischemia (stroke) model was created in SD and SHR rats by permanent middle cerebral artery occlusion (MCAO). Control rats of the same strain were subjected to a sham operation (Sham).
  • Subtraction libraries comprised genes expressed in the MCAO rats but not in the sham operated rats (MCAO-Sham), and those genes expressed in the MCAO rats treated with FK506 (taken at 3 hours and 6 hours after FK506 treatment) but not in the MCAO treated rats (which had not been subjected to MCAO treatment) in the presence of FK506 ([MCAO+FK506] ⁇ [MCAO]).
  • Another library included in the Stroke Chip was derived from in vitro treatment of primary neurons from the cerebellum of 7-day rat pups. The cells were subjected to hypoxia (0.5% O 2 ) for 16 hours.
  • the cells under hypoxia and control cells under normal oxygen concentration (nonmoxia) were treated with FK506 (100 ng/ml) at 0 hour and the cDNA extracted after 16 hours.
  • a subtraction library was made from the cDNA fragments expressed in the FK506 treated cells under hypoxia but not in the FK506 treated cells under normoxia ([Hypoxia+FK506] ⁇ [Normoxia+FK506]).
  • Additional libraries were generated by sequence-dependent gene identification (SDGI). This technique is described in co-assigned PCT application no. PCT/US01/09392.
  • SDGI libraries were prepared from brain tissues of the rats subjected to MCAO, MCAO rats three and six hours after treatment with FK506, and sham operated rats three and six hours after treatment with FK506.
  • SDGI libraries were prepared from primary neurons that were subjected to hypoxia for 16 hours in the in vitro experiments and from primary neurons, pretreated with FK506 and subjected to hypoxia for 16 hours.
  • the chip was used for differential hybridization experiments. Thus, cells, either in vivo or in vitro, were subjected to a developmental, physiological, pharmacological or other cued event that would cause genes to be activated or repressed in response thereto.
  • This gene expression array technology was disclosed, for example in U.S. Pat. No. 5,807,522.
  • Probes used for hybridizations on the Stroke chip Probe ID Treatment FJ65B 1.5 hr MCAO ⁇ cortex FJ66B 3 hr MCAO ⁇ cortex FJ67B 6 hr MCAO ⁇ cortex FJ68B 12 hr MCAO ⁇ cortex FJ69B 24 hr MCAO ⁇ cortex FJ70B 48 hr MCAO ⁇ cortex FJ71B 1.5 hr MCAO ⁇ + FK-506 cortex FJ72B 3 hr MCAO ⁇ + FK-506 cortex FJ73B 6 hr MCAO ⁇ + FK-506 cortex FJ74B 1.5 hr MCAO ⁇ whole hemisphere FJ75B 3 hr MCAO ⁇ whole hemisphere FJ76B 6 hr MCAO ⁇ whole hemisphere FJ77B 12 hr MCAO ⁇ whole hemisphere FJ78B 24 hr MCAO ⁇ whole hemisphere FJ79B
  • a common control probe was added to each hybridization (Probe A) labeled with Cy3.
  • the common control probes were mixtures of poly-A RNA extracted from the whole brain of SD rats. In each hybridization a mixture of Probe A and Probe B was used.
  • Coronal sections were prepared from paraffin blocks of sham operated rat brains and brains subjected to MCAO.
  • CRP binds to a range of substances such as phosphorylcholine, fibronectin, chromatin, histones, and ribonucleoprotein in a calcium-dependent manner. It is a ligand for specific receptors on phagocytic leukocytes, mediates activation reactions on monocytes and macrophages, and activates complement. Plasma CRP is the classical acute-phase protein, increasing 1,000-fold in response to infection, ischemia, trauma, bums, and inflammatory conditions.
  • FIG. 1 The nucleotide and amino acid sequence of the Human Narp polynucleotide (cDNA) and polypeptide (respectively) are given in FIG. 1 (SEQ ID No.'s 1 and 2 respectively).
  • the nucleotide and amino acid sequence of Rat Narp cDNA are shown in FIG. 2 (SEQ ID No.'s 3 and 4 respectively).
  • the base numbers are indicated on the left margin side.
  • the nucleotide sequence comparison between Rat, Mouse and Human (termed: nptx2) Narp is also presented, in FIG. 3 (SEQ ID No.'s 3, 5 and 1 respectively).
  • a * below the rat sequence line designates homology of mouse and human bases with the rat.
  • FIG. 4 A comparison between the predicted amino-acid sequences of Rat, Mouse, and Human Narps are shown in FIG. 4 (SEQ ID No.'s 4, 2 and 6 respectively).
  • the sign * has the same designation as in FIG. 3 .
  • the nucleotide and the amino-acid sequences of human Narp have been provided previously in U.S. Pat. No. 6,436,673.
  • the nucleotide and the amino-acid sequences of rat Narp have been provided previously in U.S. Pat. No. 5,767,252.
  • NARP is selectively enriched at excitatory synapses on neurons from both the hippocampus and spinal cord and overexpression of recombinant NARP increases the number of excitatory but not inhibitory synapses in cultured spinal neurons. Narp has several suggested functions:
  • NARP was found to be upregulated in RNA probes derived from animals subjected to MCAO in both the cortex and the ipsilateral hemisphere.
  • the upregulation was immediate ranging from 1.5 to 24 hours.
  • the peak of the upregulation is between 6 and 12 hours.
  • FK-506 known to have a beneficial effect in stroke models decreases the degree of NARP RNA upregulation by 50%.
  • the first column in Table 3 depicts the probe name, the second column indicates the differential behavior and the third the treatment description.
  • the differentials are normalized with respect to the normal controls, for example 5.1 (FJ77) means that with that particular probe the amount of NARP RNA was 5.1 times greater than in the normal control. (A differential is considered significant when it is higher than 1.7)
  • the 35 S-labeled probe specific to the NARP gene was hybridized to coronal section of rat brains fixed at different time points (1.5 hr, 3 hr, 6 hr, 12 hr, 24 hr,48 hr, 72 hr and 96 hr) after permanent middle cerebral artery occlusion (MCAO) or sham operation.
  • MCAO middle cerebral artery occlusion
  • NARP NARP-associated anti-viral RNA
  • the elevated expression of NARP was detectable in peri-infarct areas from 1.5 hr to 48 hr of MCAO while at 72 and 96 hr hybridization signal at the side ipsilateral to MCAO returned to the level seen at the contralateral side.
  • the results of the DNA microarray based experiments were confirmed by the in situ hybridization studies.
  • Portions (fragments or subunits) of the toxin taipoxin may be produced via several methods, for example:
  • Synthetic polypeptides can be made using a commercially available machine, using the known sequence of the taipoxin polypeptide or fragments thereof.
  • a preferred method of making the taipoxin polypeptides is to clone a fragment of the cDNA of the taipoxin gene into an expression vector and culture the cell harboring the vector so as to express the encoded polypeptide, and then purify the resulting polypeptide, all performed using methods known in the art (see Deutscher; Harris and Angal).
  • the expression vector can include a promoter for controlling transcription of the heterologous material and can be either a constitutive or inducible promoter to allow selective transcription. Enhancers that can be required to obtain necessary transcription levels can optionally be included.
  • the expression vehicle can also include a selection gene.
  • Vectors can be introduced into cells or tissues by any one of a variety of methods known within the art. Such methods can be found generally described in Sambrook et al., Molecular Cloning: A Laboratory Manual , Cold Springs Harbor Laboratory, New York (1989, 1992), in Ausubel et al., Current Protocols in Molecular Biology , John Wiley and Sons, Baltimore, Md. (1989), Vega et al., Gene Targeting , CRC Press, Ann Arbor, Mich. (1995), Vectors: A Survey of Molecular Cloning Vectors and Their Uses , Butterworths, Boston Mass. (1988) and Gilboa et al. (1986).
  • Subunits of the toxin taipoxin can be purified from the venom of Oxyuranus s. scutellatus , by fractionation on HPLC using ion exchange column, using a Tris-HCL buffer system, as described in Lipps (2000), Isolation of subunits, ⁇ , ⁇ and ⁇ of the complex taipoxin from the venom of Australian taipan snake ( Oxyuranus s. scutellatus ): characterization of ⁇ taipoxin as a potent mitogen . Toxicon 38: 1845–1854
  • polypeptides can be prepared according to the above Example, using the appropriate polypeptide sequence or natural source.
  • Purified Taipoxin ⁇ was dissolved in 1 ml 50 mM Na-phosphate buffer, pH 7.0, and applied to 1 ml SP-Sepharose fast flow column (Pharmacia), equilibrated with the same buffer. The major fraction was in the unbound fraction. It was collected, dialyzed against NH 4 HCO 3 , and 50 ⁇ g aliquots were lyophilized. The bound fraction was eluted with 1 M NaCl in the same buffer.
  • one method of purifying gamma-taipoxin was performed as follows: crude taipoxin, containing ⁇ , ⁇ , and ⁇ subunits, was purchased from Alomone Labs, Jerusalem. The lyophilized powder of crude taipoxin was dissolved in deionized water, lyophilized, and dissolved in 2 ml 6 M Guanidinium HCl. It was applied to Sephacryl S-200 column, equilibrated with 6 M Guanidinium HCl, and the ⁇ subunit was separated from ⁇ and ⁇ subunits by gel chromatography (Fohlman, J. et al. (1976) Eur. J. Biochem . 68, 457).
  • the fractions containing the ⁇ subunit were pooled, dialyzed into 50 mM NH 4 HCO 3 , and lyophilized.
  • the lyophilized fraction was redissolved in 6 M Guanidinium HCl and re-applied to Sephacryl S-200 column, equilibrated with 6 M Guanidinium HCl.
  • the re-chromatography was performed in order to remove traces of ⁇ and ⁇ subunits.
  • the fractions were then pooled and dialyzed into 50 mM Na-phosphate buffer pH 7.0.
  • the dialyzed fraction was applied to SP-Sepharose fast flow column (1 ml).
  • the ⁇ subunit did not bind to SP-Sepharose in these conditions.
  • the bound material, containing some residual impurities, was eluted with 1 M NaCl in 50 mM Na-phosphate buffer pH 7.0. It did not exceed 1% of the applied material.
  • the flow-through, containing the ⁇ subunit, was dialyzed into 50 mM NH 4 HCO 3 , and the protein content was spectrophotometrically calculated.
  • the gamma subunit of taipoxin was proven to be non-toxic according to the following procedures:
  • P19 differentiated neurons were prepared according to protocols known in the art. Two weeks after differentiation, gamma-taipoxin or crude taipoxin are added to the cells and cell viability is subsequently measured using Alamar Blue.
  • a concentration of 0. ug/ml of taipoxin caused cell death of ⁇ 60% of P19 undifferentiated cells and ⁇ 80% of P19 differentiated neurons. Under the selected range of concentrations, taipoxin behaves consistently, killing more than 90% of the cells.
  • a concentration of 1 ug/ml of gamma-taipoxin caused cell death of ⁇ 50% of P19 differentiated neurons, while P19 undifferentiated cells were not affected by gamma-taipoxin in the test concentrations ranging from 0.5 ug/ml to 10 ug/ml.
  • gamma-taipoxin is several hundred folds less toxic than crude taipoxin in P19 differentiated neurons.
  • the crude taipoxin was toxic in all concentrations tested (the lowest concentration was 62.5 ng/ml). By contrast, the toxicity of gamma-taipoxin was detected only at very high concentrations (IC 50 >5 ⁇ g/ml). The lower concentrations of gamma-taipoxin did not exert any toxicity. The toxicity of gamma-taipoxin is ⁇ 1% of that of the crude taipoxin.
  • CNS injury The potential of the use of anti-Narp antibody or other Narp inhibitor for treating CNS injury is evaluated in animal models. The models represent varying levels of complexity, by comparison of control animals to the antibody-treated animals. The efficacy of such treatment is evaluated in terms of clinical outcome, neurological deficit, dose-response and therapeutic window. Test animals are treated intravenously or subcutanously with anti-Narp antibody or other Narp inhibitor prepared in a suitable buffer. Control animals are treated with buffer only. Models used are as follows.
  • the efficacy of the anti-Narp antibody or other Narp inhibitors is determined by mortality rate, weight gain, infarct volume and by short and long term clinical and neurophysichological outcomes in surviving animals. Infarct volumes are assessed histologically (Knight et al., Stroke, 25, 1252, 1994, and Mintorovitch et al., Magn. Reson. Med. 18, 39, 1991).
  • the staircase test Montoya et al., J. Neurosci. Methods 36, 219, 1991
  • the motor disability scale according to Bederson's method Bederson et al., Stroke, 17, 472, 1986 are employed to evaluate the functional outcome following MCAO.
  • the animals are followed for different time points, the longest one being two months. At each time point (24h, 1 week, 3, 6, 8 weeks), animals are sacrificed and cardiac perfusion with 4% formaldehyde in PBS is performed. Brains are removed and serial coronal 200 m sections are prepared for processing and paraffin embedding. The sections are stained with suitable dyes such as TCC. The infarct area is measured in these sections using a computerized image analyzer.
  • the neuroprotective efficacy of gamma-taipoxin was evaluated in rat stroke models of permanent focal cerebral ischemia, as described herein.
  • Focal ischemia was induced by permanent coagulation of the middle cerebral artery. Rats were anesthetized with halothane (4% for induction, 1.5% for maintenance) in a mixture of 70% of nitrous oxide and 30% oxygen during surgery. Under the subtemporal craniotomy, the left MCA was exposed by a microsurgical approach and the MCA was occluded by bipolar electrocoagulation. After occlusion of the MCA, the temporalis muscle and skin were closed in layers and anesthesia was discontinued. Rectal temperature of rats was maintained at 37.0–38.5° C. with a heating-pad during the surgery.
  • mice Twenty-four hours after MCAO, rats were perfused with saline under pentobarbital anesthesia (50 mg/kg, i.p.) and their brains were removed. The brain was coronally sectioned in 2-mm thickness from +4 to ⁇ 6 mm from bregma, and then the six consecutive slices were stained with 2% 2,3,5-triphenyltetrazolium chloride (TTC) at 37° C. for 30 minutes. The area of ischemic brain damage and the whole area of cerebrum in 6 sections were calculated by using a computerized image analysis system. The brain damage was expressed as the percentage of the sum of the area of damaged brain to the sum of the whole area of cerebrum and the volume of ischemic brain damage was calculated. Statistical comparison between the vehicle-treated control and the taipoxin ⁇ -treated groups was performed by Dunnett's multiple comparison test. All results are expressed as the mean ⁇ S.E.M.
  • the rats received with i.c.v. infusion of taipoxin ⁇ showed no obvious abnormal behavior during the course of experiments.
  • Permanent occlusion of the left MCA resulted in ischemic brain damage within the territory of the MCA, i.e. in the dorsolatelal cortex and striatum.
  • Volumes of total, cortical and subcortical ischemic brain damage in the vehicle-treated control group were 255.00 ⁇ 15.14, 170.43 ⁇ 13.39 and 84.57 ⁇ 3.81 mm 3 , respectively.
  • the size of ischemic brain damage is therefore dose-dependent (Table 4).
  • the compound of the present invention is administered and dosed in accordance with good medical practice, taking into account the clinical condition of the individual patient, the disease to be treated, the site and method of administration, scheduling of administration, patient age, sex, body weight and other factors known to medical practitioners.
  • the pharmaceutically “effective amount” for purposes herein is thus determined by such considerations as are known in the art. The amount must be effective to achieve improvement including but not limited to improved survival rate or more rapid recovery, or improvement or elimination of symptoms and other indicators as are selected as appropriate measures by those skilled in the art.
  • the treatment generally has a length proportional to the length of the disease process and drug effectiveness and the patient species being treated. It is noted that humans are treated generally longer than the mice or other experimental animals exemplified herein.
  • the compound of the present invention can be administered by any of the conventional routes of administration. It should be noted that it can be administered as the compound or as pharmaceutically acceptable salt and can be administered alone or as an active ingredient in combination with pharmaceutically acceptable carriers, solvents, diluents, excipients, adjuvants and vehicles.
  • the compounds can be administered orally, subcutaneously or parenterally including intravenous, intraarterial, intramuscular, intraperitoneally, and intranasal administration as well as intrathecal and infusion techniques. Implants of the compounds are also useful. Liquid forms may be prepared for injection, the term including subcutaneous, transdermal, intravenous, intramuscular, intrathecal, and other parental routes of administration.
  • the liquid compositions include aqueous solutions, with and without organic cosolvents, aqueous or oil suspensions, emulsions with edible oils, as well as similar pharmaceutical vehicles.
  • the compositions for use in the novel treatments of the present invention may be formed as aerosols, for intranasal and like administration.
  • the patient being treated is a warm-blooded animal and, in particular, mammals including man.
  • the pharmaceutically acceptable carriers, solvents, diluents, excipients, adjuvants and vehicles as well as implant carriers generally refer to inert, non-toxic solid or liquid fillers, diluents or encapsulating material not reacting with the active ingredients of the invention.
  • compositions suitable for injection include sterile aqueous solutions or dispersions and sterile powders for reconstitution into sterile injectable solutions or dispersions.
  • the carrier can be a solvent or dispersing medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils.
  • solvent or dispersing medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, liquid polyethylene glycol, and the like), suitable mixtures thereof, and vegetable oils.
  • Proper fluidity can be maintained, for example, by the use of a coating such as lecithin, by the maintenance of the required particle size in the case of dispersion and by the use of surfactants.
  • Nonaqueous vehicles such as cottonseed oil, sesame oil, olive oil, soybean oil, corn oil, sunflower oil, or peanut oil and esters, such as isopropyl myristate, can also be used as solvent systems for compound compositions.
  • various additives which enhance the stability, sterility, and isotonicity of the compositions including antimicrobial preservatives, antioxidants, chelating agents, and buffers, can be added.
  • antibacterial and antifungal agents for example, parabens, chlorobutanol, phenol, sorbic acid, and the like.
  • isotonic agents for example, sugars, sodium chloride, and the like.
  • Prolonged absorption of the injectable pharmaceutical form can be brought about by the use of agents delaying absorption, for example, aluminum monostearate and gelatin. According to the present invention, however, any vehicle, diluent, or additive used have to be compatible with the compounds.
  • Sterile injectable solutions can be prepared by incorporating the compounds utilized in practicing the present invention in the required amount of the appropriate solvent with various of the other ingredients, as desired.
  • a pharmacological formulation of the present invention can be administered to the patient in an injectable formulation containing any compatible carrier, such as various vehicle, adjuvants, additives, and diluents; or the compounds utilized in the present invention can be administered parenterally to the patient in the form of slow-release subcutaneous implants or targeted delivery systems such as monoclonal antibodies, vectored delivery, iontophoretic, polymer matrices, liposomes, and microspheres. Examples of delivery systems useful in the present invention include: U.S. Pat. Nos.
  • a pharmacological formulation of the compound utilized in the present invention can be administered orally to the patient.
  • Conventional methods such as administering the compounds in tablets, suspensions, solutions, emulsions, capsules, powders, syrups and the like are usable.
  • Known techniques which deliver it orally or intravenously and retain the biological activity are preferred.
  • the compound of the present invention can be administered initially by intravenous injection to bring blood levels to a suitable level.
  • the patient's levels are then maintained by an oral dosage form, although other forms of administration, dependent upon the patient's condition and as indicated above, can be used.
  • Antibodies are typically administered over several days or weeks. They may be injected intravenously or subcutaneously. Antibodies acting on the central nervous system may be administered in bolus or with infusion all the time that the brain blood barrier is open (usually 24 following brain injury, either stroke or TBI.)
  • the dose and the route of administration of the antibody may vary, and will be determined by the attending physician in accordance with the medical history.
  • therapeutic antibodies against ICAM-1 were administrated to laboratory animals at a dose of 2 mg/kg over a 3 minute interval, two hours upon middle cerebral artery occlusion followed by a second administration of 1 mg/kg 22 hrs following middle cerebral artery occlusion. (Zhang R. L et al., Stroke, 26: 1438–1443, 1995).
  • the active dose for humans is in the range of from 1 ng/kg to about 20–100 mg/kg body weight per day, preferably about 0.01 mg to about 2–10 mg/kg body weight per day, in a regimen of one dose per day or twice or three or more times per day for a period of 1–2 weeks or longer, preferably for 24-to 48 hrs or by continuous infusion during a period of 1–2 weeks or longer.
  • compositions of the present invention will depend on the type of injury or disease being treated.
  • treatment of an acute event will necessitate systemic administration of the active composition comparatively rapidly after induction of the injury.
  • diminution of chronic degenerative damage may necessitate a sustained dosage regimen.
  • Delivery of compounds into the brain can be accomplished by several methods such as, inter alia, neurosurgical implants, blood-brain barrier disruption, lipid mediated transport, carrier mediated influx or efflux, plasma protein-mediated transport, receptor-mediated transcytosis, absorptive-mediated transcytosis, neuropeptide transport at the blood-brain barrier, and genetically engineering “Trojan horses” for drug targeting.
  • neurosurgical implants blood-brain barrier disruption, lipid mediated transport, carrier mediated influx or efflux, plasma protein-mediated transport, receptor-mediated transcytosis, absorptive-mediated transcytosis, neuropeptide transport at the blood-brain barrier, and genetically engineering “Trojan horses” for drug targeting.
  • the above methods are performed essentially as described in “ Brain Drug Targeting: the future of brain drug development ”, W. M. Pardridge, Cambridge University Press, Cambridge, UK (2001).
  • polypeptides such as gamma-taipoxin or fragments thereof
  • delivery of polypeptides can be accomplished by genetically engineering “Trojan horses” for drug targeting such as, for example, peptidomimetic monoclonal antibodies that are ligands for blood-barin barrier endogenous receptors.
  • the Narp gene may be used in a screening assay for identifying and isolating compounds which inhibit stroke.
  • the compounds to be screened comprise inter alia substances such as small chemical molecules, antibodies, antisense oligonucleotides, antisense DNA or RNA molecules, polypeptides and dominant negative or dominant positive peptides, and expression vectors.
  • a synthetic antisense oligonucleotide drug can inhibit translation of mRNA encoding the gene product of a gene involved in the stroke event.
  • Small chemical molecules generally have a molecular weight of less than 2000 daltons, more preferably less than 1000 daltons or even less then 600 daltons.
  • screening assays are known to those of ordinary skill in the art.
  • the specific assay which is chosen depends to a great extent on the activity of the candidate gene or the polypeptide expressed thereby.
  • an assay which is based on inhibition (or stimulation) of the enzymatic activity can be used.
  • the candidate polypeptide is known to bind to a ligand or other interactor, then the assay can be based on the inhibition of such binding or interaction.
  • the candidate gene is a known gene, then many of its properties can also be known, and these can be used to determine the best screening assay.
  • the candidate gene is novel, then some analysis and/or experimentation is appropriate in order to determine the best assay to be used to find inhibitors of the activity of that candidate gene.
  • the analysis can involve a sequence analysis to find domains in the sequence which shed light on its activity.
  • the screening assays can be cell-based or non-cell-based.
  • the cell-based assay is performed using eukaryotic cells such as HeLa cells.
  • eukaryotic cells such as HeLa cells.
  • One way of running such a cell-based assay uses tetracycline-inducible (Tet-inducible) gene expression. Tet-inducible gene expression is well known in the art; see for example, Hofmann et al, 1996, Proc Natl Acad Sci 93(11):5185–5190.
  • Tet-inducible retroviruses have been designed incorporating the Self-inactivating (SIN) feature of a 3′ Ltr enhancer/promoter retroviral deletion mutant. Expression of this vector in cells is virtually undetectable in the presence of tetracycline or other active analogs. However, in the absence of Tet, expression is turned on to maximum within 48 hours after induction, with uniform increased expression of the whole population of cells that harbor the inducible retrovirus, thus indicating that expression is regulated uniformly within the infected cell population.
  • SI Self-inactivating
  • a specific reporter gene construct can be designed such that phosphorylation of this reporter gene product causes its activation, which can be followed by a color reaction.
  • the candidate gene can be specifically induced, using the Tet-inducible system discussed above, and a comparison of induced versus non-induced genes provides a measure of reporter gene activation.
  • a reporter system can be designed that responds to changes in protein-protein interaction of the candidate protein. If the reporter responds to actual interaction with the candidate protein, a color reaction occurs.
  • a specific promoter or regulatory element controlling the activity of a candidate gene is defined by methods well known in the art.
  • a reporter gene is constructed which is controlled by the specific candidate gene promoter or regulatory elements. The DNA containing the specific promoter or regulatory agent is actually linked to the gene encoding the reporter. Reporter activity depends on specific activation of the promoter or regulatory element.
  • inhibition or stimulation of the reporter is a direct assay of stimulation/inhibition of the reporter gene; see, for example, Komarov et al (1999), Science vol 285, 1733–7 and Storz et al (1999) Analytical Biochemistry, 276, 97–104.
  • non-cell-based screening assays are also well within the skill of those of ordinary skill in the art.
  • enzymatic activity such as if the candidate protein has a kinase activity
  • the target protein can be defined and specific phosphorylation of the target can be followed.
  • the assay can involve either inhibition of target phosphorylation or stimulation of target phosphorylation, both types of assay being well known in the art; for example see Mohney et al (1998) J. Neuroscience 18, 5285 and Tang et al (1997) J Clin. Invest. 100, 1180 for measurement of kinase activity. Although this is not relevant in cases where there is no known enzymatic activity, there is a possibility that non enzyme proteins interact with an enzyme and regulate its enzymatic activity through protein-protein interaction.
  • the candidate polypeptide is immobilized on beads.
  • An interactor such as a receptor ligand, is radioactively labeled and added. When it binds to the candidate polypeptide on the bead, the amount of radioactivity carried on the beads (due to interaction with the candidate polypeptide) can be measured. The assay indicates inhibition of the interaction by measuring the amount of radioactivity on the bead.
  • any of the screening assays can include a step of identifying the chemical compound (as described above) which tests positive in the assay and can also include the further step of producing as a medicament that which has been so identified. It is considered that medicaments comprising such compounds, or chemical analogs or homologs thereof, are part of the present invention. The use of any such compounds identified for prevention or treatment of stroke or other ischemic events, is also considered to be part of the present invention.
  • Narp can be employed in several screening systems in which Narp can be employed.
  • O'Brien et al. Synaptically Targeted Narp Plays an Essential Role in the Aggregation of AMPA Receptors at Excitatory Synapses in Cultures Spinal Neurons, Journal of Neuroscience 22(11): 4487–4498, 2002, and in PCT application publication No. 97/39133.
  • Antibodies which bind to the Narp polypeptide of the invention may be prepared using an intact Narp polypeptide or fragments containing smaller polypeptides as the immunizing antigen. For example, it may be desirable to produce antibodies that specifically bind to the N- or C-terminal or any other suitable domains of Narp.
  • the polypeptide used to immunize an animal can be derived from translated cDNA or chemical synthesis which can be conjugated to a carrier protein, if desired.
  • Such commonly used carriers which are chemically coupled to the polypeptide include keyhole limpet hemocyanin (KLH), thyroglobulin, bovine serum albumin (BSA) and tetanus toxoid. The coupled polypeptide is then used to immunize the animal.
  • polyclonal or monoclonal antibodies can be further purified, for example by binding to and elution from a matrix to which the polypeptide or a peptide to which the antibodies were raised is bound.
  • Those skilled in the art know various techniques common in immunology for purification an/or concentration of polyclonal as well as monoclonal antibodies (Coligan et al, Unit 9, Current Protocols in Immunology, Wiley Interscience, 1994, incorporated by reference). Methods for making antibodies of all types, including fragments, are known in the art (See for example, Harlow and Lane, Antibodies: A Laboratory Manual, Cold Spring Harbor Laboratory, New York (1988) incorporated herein by reference). Methods of immunization, including all necessary steps of preparing the immunogen in a suitable adjuvant, determining antibody binding, isolation of antibodies, methods for obtaining monoclonal antibodies, and humanization of monoclonal antibodies are all known to the skilled artisan
  • the antibodies may be humanized antibodies or human antibodies.
  • Antibodies can be humanized using a variety of techniques known in the art including CDR-grafting (EP239,400: PCT publication WO.91/09967; U.S. Pat. Nos. 5,225,539; 5,530,101; and 5,585,089, veneering or resurfacing (EP 592,106; EP 519,596; Padlan, Molecular Immunology 28(4/5):489–498 (1991); Studnicka et al., Protein Engineering 7(6):805–814 (1994); Roguska et al., PNAS 91:969–973 (1994)), and chain shuffling (U.S. Pat. No. 5,565,332).
  • the monoclonal antibodies as defined include antibodies derived from one species (such as murine, rabbit, goat, rat, human, etc.) as well as antibodies derived from two (or more) species, such as chimeric and humanized antibodies.
  • Human antibodies are particularly desirable for therapeutic treatment of human patients.
  • Human antibodies can be made by a variety of methods known in the art including phage display methods using antibody libraries derived from human immunoglobulin sequences. See also, U.S. Pat. Nos. 4,444,887 and 4,716,11 1; and, PCT publications WO 98/46645, WO 98/50433, WO 98/24893, WO 98/16654, WO 96/34096, WO 96/33735, and WO 91/10741; each of which is incorporated herein by reference in its entirety.

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